Tricuspid Regurgitation Following Implantation of Endocardial Leads: Incidence and Predictors

Lee, Regina C.; Friedman, Sara L.; Sidhu, Mandeep S.; Kono, Alan T.; Palac, Robert T.

doi:10.1016/s0735-1097(13)62012-4

Cited by 3 publications

(3 citation statements)

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“…However, the mechanical interference between transvalvular leads and TV leaflet mobility and coaptation can result in regurgitation rendering such an approach counterintuitive [19]. The prevalence and incidence of significant TR following CIED implantation ranges from 10% to 39% with a higher risk attributable to implantable cardiac defibrillator (ICD) leads or presence of more than 1 RV lead [20][21][22][23][24][25][26][27]. The impact of pacing or defibrillation leads on the development of significant TR after TV repair or replacement has also been reported in observational retrospective studies with findings ranging from severe TR to no significant effect on the repaired TV function [28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Micra Transcatheter Pacing System Implant under Direct Visualization During Minimally Invasive Tricuspid Valve Surgery

Sinno¹

2020

JCCI

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Atrioventricular nodal conduction abnormalities are common after open heart surgery and more so during or after valve surgery. The incidence of atrioventricular (AV) block after tricuspid valve (TV) surgery is higher than what is observed following coronary artery bypass surgery or left sided valve interventions due to the proximity of the TV annulus to the AV node and hence requirements for cardiac pacing are high. However, the mechanical interference between pacing leads and TV leaflet mobility and coaptation can result in regurgitation rendering such an approach counterintuitive. We report a case of Micra Transcatheter pacing system (TPS) implant under direct visualization at the time of tricuspid valve surgery performed via a right mini-thoracotomy approach.

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Section: Discussionmentioning

confidence: 99%

Micra Transcatheter Pacing System Implant under Direct Visualization During Minimally Invasive Tricuspid Valve Surgery

Sinno¹

2020

JCCI

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“…2 This is more common with implantable cardiac defibrillators than permanent pacemakers due to differences in lead size. 3 A recent retrospective cohort study by Lee et al 5 demonstrated that right atrial area, RV systolic pressure, and the presence of moderate or greater mitral regurgitation (MR) were all correlated with an increase in TR of 2 grades or more. Although cardiac resynchronization therapy (CRT) with biventricular pacing has been shown to improve TR due to dyssynchrony, 6 lack of response to CRT can be attributed to worsening of the TR, possibly due to the lead implant itself.…”

Section: Discussionmentioning

confidence: 99%

Pacemaker-associated Right Heart Failure: An Under-recognized Problem

Fischman¹

2015

JICRM

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Patients presenting with right-sided heart failure represent a clinical challenge with numerous potential etiologies and limited treatment options. This report presents a challenging case involving right-sided heart failure due to persistent tricuspid regurgitation (TR) exacerbated by the placement of a right ventricular (RV) pacing lead after mitral valve repair. Ultimately, lead extraction resulted in decreased TR severity, improvement in RV function, and resolution of heart failure symptoms, highlighting the importance of prompt recognition of lead-associated TR.

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“…After implantation of a lead across the tricuspid valve, this is an increasingly common finding, and significant tricuspid regurgitation may occur in 10% to 39% of patients. 2,3 The patient was treated with intravenous diuretics followed by extraction of the right ventricular lead. A new lead was positioned in a posterolateral branch of coronary sinus with left ventricular capture and a significant improvement in the degree of tricuspid regurgitation.…”

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confidence: 99%